• Elihu D Richter, Paul Barach, Lee Friedman, Samuel Krikler, and Abraham Israeli.
• Hebrew University-Hadassah School of Community Medicine and Public Health, Unit of Occupational and Environmental Medicine and Injury Prevention Center, Jerusalem, Israel. elir@cc.huji.ac.il
• Am J Public Health. 2004 Apr 1; 94 (4): 568-74.

ObjectivesWe assessed the 5-year, nationwide impact on road deaths of the raise in the speed limit (November 1, 1993) on 3 major interurban highways in Israel from 90 to 100 kph.MethodsWe compared before-after trends in deaths as well as case fatality-an outcome independent of exposure (defined as vehicle-kilometers traveled).ResultsAfter the raise, speeds rose by 4.5%-9.1%. Over 5 years, there was a sustained increase in deaths (15%) and case fatality rates (38%) on all interurban roads. Corresponding increases in deaths (13%) and case fatality (24%) on urban roads indicated "speed spillover."ConclusionsImmediate increases in case fatality predicted and tracked the sustained increase in deaths from increased speeds of impact. Newtonian fourth power models predicted the effects of "small" increases in speed on large rises in case fatality rates. Countermeasures and congestion reduced the impact on deaths and case-fatality rates by more than half.

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